Discussion Question

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Chapter 10: Cultural Competence: Awareness, Sensitivity, and Respect

Chapter Highlights

Culture in community settings

Cross-cultural nursing

Cultural competence and related concepts

How culture affects health

Cultural health assessment

Question #1

Is the following statement true or false?

Culture is static, private, and inherited.

Answer to Question #1

False

Rationale: Culture is dynamic, shared, and learned.

Culture and Nursing

Culture—knowledge, values, practices, customs, and beliefs of a group

Properties of culture

Dynamic, not static

Shared, not private

Learned, not inherited

Question #2

Is the following statement true or false?

Cultural competence is an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally includes a broader critical analysis of power relations affecting health disparities.

Answer to Question #2

True

Rationale: Cultural competence is an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally includes a broader critical analysis of power relations affecting health disparities. For community health nurses, it necessitates familiarizing oneself with cultures that are represented in the communities they serve.

Cross-cultural Nursing

Cross-cultural or transcultural nursing—any nursing encounter in which the client and nurse are from different cultures

Cultural competence—considering cultural aspects of health, illness, and treatment for each client or community, as well as doing so at each stage of the nursing process

Question #3

Is the following statement true or false?

Advocates for groups that have been sociopolitically marginalized promote “cultural safety,” the ideal of considering cultural aspects of groups while working against assimilationism and repression.

Answer to Question #3

True

Rationale: Advocates for groups that have been sociopolitically marginalized promote “cultural safety,” the ideal of considering cultural aspects of groups while working against assimilationism and repression.

Institutional Cultural Competence #1

For community and public health agencies to be culturally competent, they must

Have a defined set of values and principles and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally

Institutional Cultural Competence #2

Have the capacity to

Value diversity

Conduct self-assessment

Manage the dynamics of difference

Acquire and institutionalize cultural knowledge

Adapt to diversity and the cultural contexts of the communities they serve

Question #4

Is the following statement true or false?

Cultural humility is an acknowledgment that our own beliefs are inherently better than those of our clients.

Answer to Question #4

False

Rationale: Cultural humility is an acknowledgment that everyone’s views are culturally influenced, that our own are not inherently better than those of our clients, and that our clients can teach us.

Cultural Safety

Culturally appropriate health services to disadvantaged groups while stressing dignity and avoiding institutional racism, assimilationism, and repressive practices

Cultural Humility

Ask open-ended questions about beliefs and practices of the client and family.

Ask about traditions. What does the client think may have caused an illness, and how has the client already tried to address it?

Question #5

Is the following statement true or false?

Ethnocentrism can be defined as an assumption that everyone shares your cultural values, or an opinion that your culture is superior to others.

Answer to Question #5

True

Rationale: Ethnocentrism can be defined as an assumption that everyone shares your cultural values, or an opinion that your culture is superior to others.

Ethnocentrism

Assumption that others believe and behave as the dominant culture does, or the belief that the dominant culture is superior to others

Subculture

Group sharing some practices, language, or other characteristics in common, within a larger society that does not share those characteristics

Race

Race can be thought of as a subculture

Race is a social construct, not a biologic entity

More genetic variation within a “race” than between races

Western Biomedicine as “Cultured”

The first imperative of cultural competence is to be competent in one’s own cultural heritage.

Aspects of Culture Directly Affecting Health and Health Care #1

Attribution of illness

Diet

Verbal communication

Nonverbal communication

Eye contact

Personal space

Style of communication

Aspects of Culture Directly Affecting Health and Health Care #2

Time orientation

Roles

Religion

Folk medicine

Cultural Health Assessment

Individual clinicians

Healthcare organizations